PROJECT SUMMARY A 2009 study found that 4 out of 5 surgical residents extended their training beyond residency because they did not feel adequately trained to practice independently[1]. Medical program directors identified 121 surgical procedures that they considered essential to a surgeon's training[1]. However, 31 of these procedures (about 25% of all essential procedures) were found on average to be performed less than once by residents before completion of residency[1]. Traditional forms of surgical training, such as the use of cadavers or medical manikins, lack the fluid dynamic response to incisions, may not have identical anatomy (e.g. porcine), and may be difficult to procure. In addition, opportunities to perform actual surgeries are very limited. Medical schools have begun utilizing VR surgery simulation software, such as Touch Surgery, which can realistically simulate the human body but lacks the hands-on aspect of a real operation. VR surgery simulation technology has been shown to have a transfer-effectiveness ratio (TER) of 2.28 or, in other words, for every minute spent using VR training an equivalent of 2.28 minutes using traditional training was saved[8]. Despite these benefits, however, current VR training methods have a serious limitation: the software user must interact through a tablet or joystick and does not hold the surgical tools or receive tactile feedback, which diminishes the skill's transfer effectiveness. As part of a previous research project, Lynntech developed an electromechanical device that uses biomimetic artificial muscle fibers to move muscle-damaged fingers. We propose to transform this device into a hand-worn peripheral to provide residents with the hand-tool interactions needed to realistically simulate a surgery. In this way, the user will be able to hold, rotate, and move objects during the simulated surgery and therefore practice movements needed in an actual surgery without the bulky or restrictive gloves now available. The goal is to develop the VR Grip to increase the TER through more realistic training, leading to fewer complications in actual surgeries. The following aims will be achieved: (1) develop the VR Grip glove, (2) demonstrate that it can be tracked as it moves, (3) demonstrate that it can stop finger movements when encountering virtual objects, and (4) develop the complete workstation. The final product is expected to be a complete workstation that includes a VR headset, the VR Grip glove, a connected computer, interface software, and a VR simulated environment with pre-programmed virtual objects such as scalpels. In the Phase II follow-on efforts, the VR Grip will interface with Touch Surgery VR software, and an IRB-approved human study with surgical residents will be conducted to verify the improved TER. The VR Grip could also be used in the training of nurses and EMTs in procedures such as central venous catheter (CVC) insertion.